Medical Education

The Med Student and "The Wiz"

Dr. Sarah Diekman, MD., MS., 2L

You may be surprised to hear that one of my favorite parts of medical school was working in Wishard Memorial Hospital in Indianapolis, built in 1910. At the time of my training it was rumored to be the second oldest operating hospital in the United States. Just before my graduation in 2013 it was replaced by a gleaming state of the art beauty. I suppose it was it's time to say goodbye but I want to memorialize the living history that was “The Wiz.”

I must first say, Wishard was a fantastic teaching institution and the doctors who labored there are true American heroes. The hospital they worked in was OLD. Every bit of it beaten and battered except for a miraculously modern burn unit. As for the rest of it, every tile that was supposed to be white was yellow. Every tile that was supposed to be yellow was brown. Despite constant diligent cleaning, it never felt clean. Humanity burst forth from every corner of the Wiz. The design was not centralized, due to the expansion of the hospital over the years. Around every bend was a doctor's office and a patient looking for help. I was late to one of my first meetings, walking past the correct door several times because doctors’ offices are no longer located directly off main hallways like they were “back in the day.”

The rumors and stories of Wishard were endless. Everything from roaches falling from the ceiling of the failing infrastructure to ghosts in the psych ward. I never saw a ghost but I did sleep in the old psych ward during my surgery rotations. I didn’t need to see a ghost to feel eerie in my surrounding. I don’t know when they closed the psych wing but it boasted evidence of treatments that would now be illegal per their ineffective and cruel nature. There are museums of psychiatric history but Wishard was a living one. I walked down the profoundly long halls at night, empty but for the handful of surgery residents on call sleeping in closed rooms. I cannot totally recall but I believe sections of the unit did not have lighting, as the building was so old it need to be wired and then rewired multiple times. The room that struck me the hardest was the “hydrotherapy” room. I stared at the locked door with only a simple engraved sign, telling me of the countless human sufferings that had happened behind it. Patients being blasted with freezing water against their will, or restrained and submerged up to their neck for hours. So much misunderstanding and so much pain,now silent and observed by one medical student curious to learn from the past.

In the midnight hour of another surgery call, the residents took me and another student to see the surgery amphitheater (pictured to the left). With my iPhone, I took those photos of a room built before a cell phone was even conceptualized. In fact, that room was built before much of modern medicine and technology was conceptualized. Notice those windows? Those are not for beauty, those are for light! The knob and tube lighting at the time was hardly our surgery lights of today. The light from those windows was needed to perform surgery!!! And the online lectures of today were then medical students standing on those stairs straining to see the surgeon perform. Talk about compounding advantage! (Malcolm Gladwell). If you were a student banished to the top row, how did you learn anything? And if you didn’t learn anything, how did you get promoted to the bottom row? Also, let's think of the patient! Endotracheal tubing was in its infancy with anesthesia being iffy at best. Aseptic technique was still controversial, so who can say when it started being used in that room. This amphitheater is almost identical to that depicted in “The Gross Clinic,” so famous for its artistry and infamous for its pre -aseptic culture.

I wondered if a female doctor had ever been educated in that room? Or a minority doctor? Certainly Wishard had moved past it misogynistic and racist past, but when? Had this amphitheater been closed before or after? I will never know. I did get a rude awakening that the “new” surgery wing was not intended for female doctors when I walked into the male locker room while my superior was changing, because the door was labeled: Doctors Locker Room. The culture carried forward that doctors’ locker room meant male doctor’s locker room. The sign was never updated. When it was created: doctor = man. Those were simpler times. As it was, I was not in a simple time and had just made eye contact with my half naked superior. My female self eventually found my way to the room labeled: Women’s bathroom. It got the job done but the echoes of the misogynistic past were undeniable.

It was wild and humbling to work in such a place. Wild because of the chaos of trying to perform modern medicine in a hospital of the past. Humbling to think of the shoulders that I stood on. Who was the first woman to enter a medical class there? Who was the first minority? Who was the first to have a disability? What did they endure? What kept them going? What did they change, so that now I don’t have to? Very humbling. Wishard likely produced one of the highest volumes of doctors in the USA because it operated for so long and Indiana School of Medicine is one of the largest in the country. Now those students will be educated in the gorgeous hospital that replaced the Wiz. Sadly, but appropriately, it takes a new name, Eskenazi. It is a new era of medicine. One where the surgery suites provide their own lighting, sterile technique is gospel and medical students of all genders and races watch surgeries in HD from their living room. It is probably ironic that as someone who fights so hard to take medicine into the future feels so nostalgic about a monument of the past. A past that I am very glad is over. I think I liked the Wiz because it was a reminder of how far we have come. I get frustrated sometimes because I see how far we still have to go before we obtain justice in medicine. The Wiz reminded me that progress happens like a force of nature. Those who seek the truth and answer to their conscience will find themselves on the right side of history, albeit laughing at the med student who followed them, and can’t even get herself into the correct locker room.

The Importance and Challenge of Teaching Science

by Mathias Sleigh Kerr, teacher of science at Lake Forest Academy

The hardest part about teaching science is also one of its more unique qualities. That quality is, there are different ways to understand it. Not the facts of science, those are set facts as we know them today. The trick to science is understanding the pathways, and the processes that define those facts. That is where the importance of teaching comes in.

Today, anyone can look up the answers. There are databases upon databases, and algorithms that can lead the most laymen person to those answers. But, even with all the answers at one’s finger tips, the most important part of science is to understand the answers. To be a teacher of science, you are responsible for guiding the students through the processes to develop the understanding. The hard part is that just like roads, there can be multiple routes to get to a destination. Think of yourself, I am sure there was a time in your learning that you can recall understanding a process differently than the way a professor taught it. To be a good teacher you need to remember that experience. As you present the material to the students, not all are going to understand the process in the precise manner that you present it. This means that you need be ready to understand the material so well, that you can explain it in different ways. The best teachers know more than just the route to the destination, they know the whole map.

The true importance of science is in the understanding of how it works. When we know how the mechanics work, then one can learn how to dismantle as in fighting disease, or in the improving of the machine. Health, medicine, life, these are the benefits that come from understanding. Teaching is not just about teaching about what is known now. It is about enabling your students to one day know it better than the teachers.